Variant of Normal Flashcards
Palatine Torus/Torus Palatinus
- Tori are incredibly common, a normal of variant
- Part of physical exam is to visualize as well as running index finger over the hard palate every time
- Sometimes, torus palatinus is quite small and unnoticeable until you touch it (feel a hard bump and it’s just a bony growth)
- Sometimes, they are pedunculated; Sometimes, they get so large they become traumatized; vascular supply on surface can sometimes form ulcerations and even get a little bone exposure.
- If patient with history of use of bisphosphonates (bone modifying agents given to women who have osteoporosis or osteopenia and to prevent metastesis for certain cancers), he will remove that dead bone, and it will slowly heal. That’s one of the perils of having an enlarged palatine torus
What is this clinical finding?
Palatine Torus/Torus Palatinus
What is this clinical finding?
Palatine Torus/Torus Palatinus
Mandibular Torus: Torus Mandibularis
- Sometimes pt’s tori are so large that the sublingual frenum gets stuck underneath
- repeated irritation/trauma can create a little white rim on the tori
- these tori are rock hard and may grow overtime, but we don’t really understand why people get them
What is this clinical finding?
Mandibular Torus:
Torus Mandibularis
What is this clinical finding?
Mandibular Torus:
Torus Mandibularis
Buccal Exostoses
- Sometimes patient develops exostoses (another word for torus).
- Can get buccal exostoses, all just bone. Can pick these up on radiograph, the bone is a lot denser.
Why does it happen?
- Maybe it’s related to parafunctional habits – but don’t really understand the
- basis for the exostosis.
- They’re going to be bilateral. If it’s unilateral, we start thinking about other bony diseases
a variant of normal
What is this clinical finding?
Buccal Exostoses
Unencapsulated Lymphoid Aggregates
- the lymphoid aggregates are part of the foliate papillae (they contain some taste buds as well).
- This is lymphoid tissue -- when you get a cold or upper respiratory tract infection, sometimes these areas can become hyperplastic in response to infection – can become a little enlarged.
- These are usually bilateral.
- a variant of normal
What is this clinical finding?
Unencapsulated Lymphoid Aggregates
What is Lymphoepithelial
cyst?
a cystic structure.develops in that area where there are already unencapsulated lymphoid tissue.
This is not normal – Pathologic
Sometimes when you get a cyst in this area – because of lymphoid tissue, you can develop lymphoepithelial cyst – a tiny yellowish cyst. we see the blood vessels on the surface; this is quite characteristic.
What is this clinical finding?
Lymphoepithelial
cyst
we see a tiny yellowish cyst. we see the blood vessels on the surface; this is quite characteristic.
What is this clinical finding?
Unencapsulated
Lymphoid
Aggregates
Post-tonsillectomy
Can even develop these on area of tonsils.
(left pic) Red/salmon is a lymphoid aggregate (unencapsulated lymphoid tissue). This is someone
who had a tonsillectomy , and you can see these
lymphoid aggregates on posterior pharyngeal wall (salmon color).They move around the area.
(right pic) It grew back even in post-tonsillectomy patients.
Fordyce Granules
- Occurs on the buccal labial mucosa, retro molar pad and tonsillar area and lips
- They are white or yellow ectopic sebaceous glands
- They can be present in small or large quantity
- Why do we have sebaceous glands in mouth? we dont know, evolutionary advantage? we don’t really understand.
- a variant of normal
What is this clinical finding?
Fordyce Granules